The author is a privileged observer. Working since 15 years as a surgical pathologist, he began his career as resident of JM Coindre, PhD, a famous international expert on sarcoma. After being assistant in the pathology department of St Louis hospital, Paris, he is now head of the pathology department of a public hospital in France. He has published several papers in Human Pathology. This article is the fruit of years of work experiences and doubts. The reading of the philosophes like Michel Foucault or Jean Baudrillard have been of high value to think about pathology more globally.

Resumo

Surgical pathology is the medical specialty in charge of cancer diagnosis. Although very important since oncology development, its link with overdiagnosis and overtreatment remains understudied. Despite big mediatisation, molecular biology has not brought much progress to tumour classifications. On the contrary, the silent apparition of immunohistochemistry at the end of the 1980's improved much of tumour classifications so significantly that it could cast doubts in some trials’ results of that period. This article discusses how the booming and abuse of immunohistochemistry might have led to overdiagnosis. It also highlights that the ISO 15189 standardization, as well as the tumour classification complexity, might function to induce overtreatment. In summary, critical reading and understanding of pathology reports by general practitioners are essential. Therefore, family doctors should not hesitate to discuss the cancer diagnosis with the pathologist, and in some cases also question the oncologist decision. This approach can be considered a quaternary prevention action which can prevent overtreatment.